Doctors Hospital okayed

Williamsburg — Health commissioner Karen Remley gave the green light Tuesday for Riverside Health System’s Doctors Hospital of Williamsburg as well as for six additional beds at Sentara Williamsburg Regional Medical Center.

The victory is Pyrrhic for Sentara, which would have to spend millions to open the approved beds.

Doctors Hospital will be allowed 30 medical-surgical beds and 10 intensive-care beds at a cost of $72.4 million. Remley also approved two operating rooms at the hospital despite a recommendation from the Office of Licensure & Certification that the hospital be built without operating rooms.

Remley, as part of the Certificate of Public Need for Doctors Hospital, approved Riverside’s offer to close 20 beds at Riverside Regional Medical Center and shift another 40 beds from Riverside Regional to avoid adding new beds to the health planning district. As part of the musical beds, the certificate also calls for the closure of one operating room at Riverside Regional in Newport News.

The six medical-surgical beds at Sentara will require the construction of a sixth floor at a cost of $11.2 million.

In the cover letter of her 33-page decision, Dr. Remley discussed the reasons for her recommendation of both applications. She once worked for Sentara.

“The Doctors Hospital project presents an opportunity to parlay, through relocation, underutilized inpatient resources, all located within one planning district and from a geographical area served well by existing acute care resources to a geographical area that is experiencing development and population growth and aging,” she wrote.

Remley was pleased with Riverside’s plan to shift and close beds from Riverside Regional, saying that it is a reduction of “unneeded resources.”

She also mentioned the new criteria passed by the General Assembly last year that required her to consider access, competition and community support for a hospital.

“The current Doctors Hospital project is meaningfully consonant with these statutory changes and the purposes underlying them,” she wrote.

As for Sentara, Remley felt that while there may not be an immediate need for more beds at the hospital, there will be soon.

“The Sentara Williamsburg project may not be an incremental response to a currently confronted, facility specific expression of public need for additional resources, but recent and anticipated growth in inpatient utilization indicates a public need for these beds,” she wrote.

Riverside execs spent the day celebrating. “There are a lot of people who are happy around here,” said David Tate Jr., senior vice president for development. “We’ve worked for this for a long time, and we really do think the area needs this. We are gratified by the health commissioner’s decision. It ratified a lot of people in the community’s faith in us to get this project on track.”

Riverside had filed two previous applications for Doctors Hospital. The first application, filed in 2005, featured a 69-bed hospital at a cost of $82 million. The second attempt reduced the number of beds to 43 and the cost to $76 million.

Tate said that he was pleased that the commissioner focused on the shifting of beds and the new criteria.

“We think it was important, and it clearly played a role in the decision,” he said.

Del. Phil Hamilton (R-93rd) said that reformed Certificate of Public Need laws passed by the General Assembly aided in getting approval for the facility. His bill this year cut the criteria examined in granting the certificate from 21 to 8.

“I think the emphasis on documented public support and institutional competitiveness we put in indicated a new direction,” he said.

Tate is fine with the six beds at Sentara.

“We don’t think it has an adverse effect on our project at all,” he said. “I’ve always believed that in the greater Williamsburg community two hospitals could co-exist. We learned how to compete with each other, and I’d like to learn to cooperate with each other too.”

Sentara Williamsburg administrator Robert Graves, in an e-mail, maintained his stance for one hospital.

“While we continue to believe that the Williamsburg area is better served by one full-service hospital with ample capacity, we respect the COPN process and the importance of comprehensive health care planning,” he said.

Graves had previously said that Sentara’s occupancy rate was at 60% and that on an average day there were 55-60 empty beds.

With 40 new beds at Doctors Hospital, it’s unclear whether six more beds at Sentara will be needed.

“We are currently working through the decision and we will review our plans over the coming weeks,” Graves said. “Our main priority is to ensure that the community has access to high-quality care. This commitment has been demonstrated time and again as we invested more than $130 million in the development of a new hospital and campus.

“Our future plans will be based on community need and how to ensure the highest quality care to our patients,” he said.

Dr. Mark Ellis, chairman of the advisory board for Doctors Hospital, was thrilled. “It is very special to work for nearly five years and then to see it finally come to fruition,” he said.

Ellis has championed competition.

“My feelings have always been when you have choice in health care or anything, that drives competitors to improve quality and hopefully drive down cost,” he said. “There has been a lot of excitement from the consumer. Those are the folks I think will be as excited as anybody because they now have a choice.”

Ellis also said the new hospital at Quarterpath will provide better access to citizens in Williamsburg and south to Grove. “We think it’s an ideal location.”

Riverside staff weren’t the only ones celebrating.

“I think it’s good for the future of Williamsburg and our citizens,” said Mayor Jeanne Zeidler. “Now people will have a choice, and Williamsburg will have a hospital in another location that will be closer to some parts of our community.

“As wonderful as Sentara is, it is quite a ways from the city and the lower part of James City,” she added. “To have something more accessible for people on this end of the community is a very good thing.”

“I think it’s a very good thing and it’s been a long time coming,” said James City supervisor chairman Jim Kennedy. “This certainly opens up some competition in the Historic Triangle. I think it’ll be great for the constituents. For some of the constituents, it will limit the response times in case of emergencies.”

Riverside now moves into the design and development phase of the hospital.

Last December, Riverside presented plans to the city Architectural Review Board for medical offices and an urgent care facility at the Quarterpath site.

Tate said the approval of the hospital makes the urgent care center moot since there will be an emergency room in the hospital. Riverside will have to reconfigure the design of the medical campus.

There have been preliminary site plans and schematics under way for Doctors Hospital in anticipation of the project’s approval.

The certificate has a completion date for the hospital of January 2012. Tate said it’s unlikely they can break ground before next year. “Certainly we will not get anything started this year on the hospital proper, but we have people at work on it today.”